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Characteristics and outcomes of patients with stent implantation for coronary artery lesions caused by Kawasaki disease – insights from second-generation stent implantation

Published online by Cambridge University Press:  30 October 2024

Natsuko Ishi  and
Etsuko Tsuda Open the ORCID record for Etsuko Tsuda [Opens in a new window]
Natsuko Ishi
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan Department of Cardiology and Geriatrics, Kochi Medical School Hospital, Nangoku, Kochi, Japan
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
*
Corresponding author: E. Tsuda; E-mail: [email protected]
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Abstract

Background:

Adult Kawasaki patients may require intervention for occlusive coronary artery disease. Some adverse effects of first-generation drug-eluting stent implantation with sirolimus have been reported in this population.

Methods:

A total of nine lesions in eight (seven males, one female) patients who underwent stent implantations in this population between 2000 and 2021 were reviewed.

Results:

The age at stent implantation ranged from 31 to 47 years, with a median of 37 years. There were six lesions treated by primary percutaneous transluminal coronary interventions, and three by elective procedures. A coronary aneurysm was found in two lesions, and coronary artery calcification was found in all culprit lesions. The numbers of everolimus-eluting stents, sirolimus-eluting stents and bare metal stents were six, two, and one, respectively. As anti- thrombotic therapy, aspirin, clopidogrel, and prasugrel were given to four, three, and one, respectively. Warfarin was given to five patients. The follow-up ranged from 2 to 12 years, with a median of 4 years. Follow-up angiograms were performed for eight lesions, at 2 to 38 months, with a median of 11 months. The patency of the target vessel was confirmed in all eight vessels. Slight malapposition, and peri-stent contrast staining were found in two lesions each.

Conclusion:

Acute coronary syndrome due to coronary artery lesions caused by Kawasaki disease occurred, even in lesions without any apparent coronary artery aneurysms. In our study, we show safe and efficacious placement of second-generation stent without adverse effects during the short-term follow-up, but long-term follow-up is needed to determine the efficacy and complication.

Keywords

Kawasaki DiseaseAcute coronary syndromeStent implantationPercutaneous coronary intervention
Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 1 , January 2025 , pp. 75 - 81
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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